BackgroundIn recent years， the prevalence of depression among adolescents has risen steadily， alongside an increasing prominence of non-suicidal self-injury （NSSI） behaviors in this population， which may elevate suicide risk and constitute a serious public health problem. Negative emotions such as anxiety and depression are closely related to NSSI behaviors. Previous studies have predominantly relied on retrospective reports， limiting the ability to dynamically capture temporal relationships between emotional fluctuations and NSSI behaviors. Moreover， cognitive behavioral therapy （CBT） often lacks targeted design to address proximal triggers in interventions for NSSI behaviors. ObjectiveTo verify that anxiety as a proximal trigger factor for NSSI behaviors in adolescent patients with depression， and to evaluate the efficacy of modified CBT integrated with ecological momentary assessment （EMA） data in alleviating their anxiety and self-injury urges. MethodsA prospective cohort study design was adopted. A total of 132 adolescent patients with a history of NSSI behaviors who were treated at Jiujiang Fifth People's Hospital from January to December 2024 and met the diagnostic criteria for depression in the Diagnosed and Statistical Manual of Mental Disorders， fifth edition （DSM-5）. A smartphone-based EMA application to conduct natural situation emotions on participants for 14 consecutive days. The monitoring period spanned from 10∶00 to 22∶00 daily， with randomized assessments pushed every 2 hours. The assessment tools included the Self-rating Anxiety Scale （SAS） and the negative affect subscale of the Positive and Negative Affect Schedule （PANAS）， with real-time recording of NSSI behaviors and emotional states before and after their occurrence. Repeated measures analysis of variance was used to compare the dynamic changes in the scores of each scale before and after the episodes of NSSI behaviors. A modified CBT was administered to 83 participants who completed EMA data collection， with sessions conducted once weekly for 12 weeks. Anxiety levels were accessed using the SAS， and the self-injury urges was evaluated using the Ottawa Self-injury Inventory （OSI） before and after the intervention. ResultsEMA data revealed that SAS scores were significantly higher during the 1-2 hours before NSSI episodes compared to baseline periods ［（56.19±11.06）vs.（52.83±10.25），P<0.01］. SAS scores were positively correlated with the NSSI behavioral scores （r=0.460，P<0.01，95% CI：0.310-0.580）. After receiving modified CBT intervention， adolescent patients with depression demonstrated statistically significant decreases in both SAS scores ［（52.30±8.10） vs.（48.70±7.30），t（82）=4.820，P<0.01，Cohen's d=0.420］ and the OSI self-injury impulse subcale scores ［（12.80±2.70） vs.（9.60±2.50），t（82）=5.170，P<0.01，Cohen's d=0.510］ compared to their pre-intervention levels. ConclusionAnxiety may serve as a proximal trigger for NSSI behaviors in adolescent patients with depression. Modified CBT integrating EMA data could potentially alleviate their anxiety level and self-injury urges. ［Funded by Science and Technology Plan Project of Jiangxi Provincial Health Commission （number， SKJP220227629）］

Extracorporeal membrane oxygenation is an extracorporeal life support technique used to rescue patients with respiratory and (or) heart failure. Infection is one of the most serious complications of extracorporeal membrane oxygenation, which can affect patients' clinical outcomes. This article reviews the definition, diagnosis, incidence, site of infection, pathogenic bacteria, risk factors, prevention and treatment measures of extracorporeal membrane oxygenation associated nosocomial infection, so as to provide reference for the prevention and treatment of extracorporeal membrane oxygenation associated nosocomial infection.

Objective:To measure the partial parameters of the soft tissues of upper eyelid in young women with single eyelid in Shantou City, Guangdong Province, and to explore the asymmetry rate of the left and right palpebral fissure and its regularity.Methods:From March 2018 to July 2019, the Medical Cosmetology Center of the First Affiliated Hospital of Shantou University Medical College measured 108 young women with single eyelid, aged 18-35 years, with an average age of 24.6 years. Before operation, palpebral fissure width (PFW), palpebral fissure height (PFH), palpebral fissure inclination (PFI) and central eyebrow height (CEH) were measured. The resected intra-orbital septum fat pad during the procedure was weighed. Both direct measurement and the photo measurement were used to obtain the average value of the two sets of data for final analysis. We calculated out the incidence rate of asymmetry of each palpebral item.Results:The paired t-test showed that the mean value of PFW was (25.76±1.50) mm on the left and (26.04±1.55) mm on the right ( t=2.93); the mean value of PFH was (9.70±1.15) mm on the left and (9.49±1.05) mm on the right ( t=3.12); the mean value of PFI was (9.77±2.57)° on the left and (9.67±2.28)° on the right ( t=2.01); the mean value of CEH was (12.05±1.61) mm on the left and (12.32±1.69) mm on the right ( t=-2.66); the mean value of the weight of the intra-orbital septum fat pad was (0.20±0.11) g on the left and (0.22±0.12) g on the right ( t=2.29). There were significant differences between the two sets of data (all P<0.05). Conclusions:The asymmetric phenomenon of the upper eyelid is commonly found in Shantou young female undergraduates, in which the PFH in the left is higher than that in the left; the PFW, the CEH, the weight of the intra-orbital septum fat pad in the right more commonly found than that in the left.. This study provides a certain reference for the clinical evaluation of the operation.

This paper reviews the research status of the training and certification of extracorporeal membrane oxygenation nurses at home and abroad and their job competencies, and analyzes its limitations, so as to provide a reference for the training of extracorporeal membrane oxygenation nurses in my country.

Objective:To investigate the effects of pre-existing antibody on seroconversion rate after influenza vaccination.Methods:This study recruited 1 900 healthy volunteers to receive influenza split vaccines in Xinjiang Uygur Autonomous region and Yunnan Province from September 2009 to October 2018. Hemagglutinin agglutination inhibition assay was used to detect the titers of specific antibodies in blood samples collected before vaccination and 28 d after vaccination and the effects of pre-existing antibody on the seroconversion to different influenza vaccine components were analyzed.Results:Trend analysis showed that with the increasing titer of pre-existing antibody, the seroconversion rates to A/H1N1, A/H3N2, B/Victoria and B/Yamagata vaccine components were gradually decreased (χ 2=121.76, P<0.001; χ 2=67.58, P<0.001; χ 2=45.25, P<0.001; χ 2=54.55, P<0.001). After adjusting for factors such as region, gender and age, multivariate logistic regression showed that pre-existing antibody titer equal to or higher than 40 was an independent factor that affected the seroconversion to A/H1N1, A/H3N2 and B/Victoria vaccine components, and the adjusted OR (95%CI) values were 2.50(2.00-3.13)、1.64(1.35-2.00) and 2.50(1.79-3.45), respectively. Conclusions:The seroconversion rate to each vaccine component was negatively correlated with the pre-existing antibody titer. The factor that pre-existing antibody titer equal to or higher than 40 was detrimental to the seroconversion to A/H1N1, A/H3N2 and B/Victoria vaccine components, but had no significant influence on B/Yamagata seroconversion.

Objective:The antigenic and genetic characteristics of influenza A(H1N1)pdm09 virus isolated from the mainland of China during the 2018-2019 influenza surveillance year were analyzed.Methods:Two thousand nine hundred and fifty-eight influenza A(H1N1)pdm09 virus strains in the 2018-2019 influenza surveillance year were analyzed by hemagglutination inhibition test. The hemagglutinin(HA) gene of 279 influenza A(H1N1)pdm09 virus strains was sequenced and analyzed. The representative strains of the dominant clades were performed for antigenic characteristics using post-vaccination human antisera.Results:Two thousand eight hundred and sixty-one (97%, 2 861/2 958) viruses characterized were antigenically similar to A/Michigan/45/2015. All HA gene of the sequenced viruses belonged to 6B.1 clade, and 269(96%, 269/279) viruses belonged to 6B.1A subclade. Compared with the vaccine virus, it had the common amino acid substitutions of S74R, S164T and I295V in the HA protein. There were several small groups with common amino acid substitutions in the 6B.1A subclade, and 51% sequenced viruses had S183P amino acid substitution in this subclade. The result of antigenic analysis using post-vaccination human antiserums showed that most of the representative strains were well inhibited by the sera.Conclusions:The antigenicity of influenza A(H1N1)pdm09 viruses in the mainland of China in 2018-2019 influenza surveillance year matched well with the corresponding vaccine strain, but the HA gene had genetically diverse characteristic.

Objective: Influenza H1N1 subtype vaccine candidate strains from a 2015—2016 year epidemic strain in China were prepared and identified by themethod of classical reassortment. Methods: The influenza H1N1 epidemic strain and H3N2 high-yield reassortant parental strain (X-157) were mixed and inoculated into embryonated chicken eggs by the classical reassortmentmethod . The negative selection of mixed culture virus was carried out with the antiserum of H3 protein and the antiserum of X-157 strain. Real-time PCRmethod was used to test the HA and NA genes. Restriction enzyme digestionmethod was used to identify the internal genes. HA and NA genes of selected strains were sequenced. The strain which HA and NA genes possessed the same amino acid constitution with the wild type virus was selected and immunized to ferret. Two-way test was carried out. Results: Five strains with expected HA and NA genes were selected by real-time PCR. Internal genes were identified, with 4 strains had 6+ 2 constitution, 1 strain had 5+ 3 constitution. Comparing with the wild type virus, HA and NA genes of the 5 strains had no mutation. HA titer of reassortant strains was above 1 024. HI titer of the selected NO.12 reassortment strain reached 5 120, and two-way test was passed. The yield of reassortant strain was 64 times that of the wild type strain. Conclusions A circulating influenza A (H1N1) strain of influenza A (2015—2016) was successfully prepared in China and laid the foundation for vaccine storage and disease prevention and control.

OBJECTIVE:To establish the method for simultaneous determination of 6 residual organic solvents in Xingnaojing injection,such as methanol,ethanol,isopropanol,n-butanol,ethyl acetate and acetonitrile.METHODS:Headspace GC method was adopted.The determination was performed on DB-624 capillary column by temperature programming with the injector temperature of 200 ℃;flame ionization detector was adopted with the temperature of 250 ℃;carrier gas was nitrogen with flow rate of 25 mL/min and split ratio of 35 ∶ 1;headspace sampling size was 1 mL,and heating temperature of headspace sampling was 80 ℃;equilibrium time was 15 min.RESULTS:The linear ranges of methanol,ethanol,isopropanol,n-butanol,ethyl acetate and acetonitrile were 15.00-240.00 μg/mL (r =0.999 9),25.00-400.00 μg/mL (r =0.999 9),25.00-400.00 μg/mL (r =0.999 9),25.00-399.99 μg/mL(r=0.999 9),25.00-399.99 μg/mL(r=0.999 8) and 5.00-80.00 μg/mL(r=0.999 9).The LOQ were 5.98,3.94,2.05,2.13,1.39,1.24 μg/mL,and the LOD were 2.01,2.11,1.18,1.56,1.15,0.01 μg/mL,respectively.RSDs of precision tests were all less than 2.0％,stability and repetitive tests only ethyl acetate was detected,RSD＜2.0％;the recoveries were 93.59％-99.02％ (RSD=2.62％,n=6),92.42％-98.40％ (RSD=2.43％,n=6),94.81％-104.64％ (RSD=3.47 ％,n=6),94.56％-106.73％ (RSD=4.21％,n=6),97.04％-106.33％(RSD=3.50％,n=6)and 98.40％-107.97％ (RSD=3.37％,n=6).CONCLUSIONS:The method is specific,rapid,simple and accurate,and can be used for simultaneous determination of 6 residual organic solvents in Xingnaojing injection.

Objective:To discuss the effect and significance of reasonable medication review mode for intravenous medical advice on the platform of pharmacy intravenous admixture service( PIVAS) . Methods:The effect of prescription review interference in intrave-nous drugs on the platform of PIVAS was studied through analyzing irrational prescriptions before and after the performance of PIVAS for 25 departments in our hospital. Results:The real-time review and interference procedure for intravenous transfusion was established, which could significantly increase the percentage of reviewed medical advice and the correction rate of irrational medical advice, and re-duce the percentage of irrational medical advice. The medical advice review quality was also increased, which could guarantee the med-ication safety in patients. Conclusion:The real-time review and interference procedure for intravenous transfusion on the platform of PIVAS can significantly improve the rational medication level of intravenous drugs and avoid the hidden danger of irrational medical ad-vice to the maximum extent to ensure the medication safety in patients, which is also beneficial to the provision of medication service and new platform establishment for the development of clinical pharmacy in hospitals.

Objective To analyze the phenotypic characteristics of antiviral-resistant influenza B viruses circulating in mainland China and to analyze the susceptibility of influenza B viruses to neuraminidase inhibitors ( NAIs) . Methods Antiviral-resistant phenotyping test was performed to analyze the NAI suscep-tibility of 1 386 influenza B viruses isolated in mainland China from April 2014 to March 2015, including the test of susceptibility to oseltamivir and zanamivir. Results All of the 94 B-Victoria lineage viruses were sensitive to oseltamivir and zanamivir. Of all 1 292 B-Yamagata lineage viruses tested, 1 virus showed re-duced sensitivity to oseltamivir with NA gene containing I221T amino acid mutation, 10 viruses showed re-duced sensitivity to zanamivir with 4 having D197N amino acid mutation in NA gene, 3 viruses showed re-duced sensitivity to both oseltamivir and zanamivir with NA gene possessing D197N amino acid mutation and 1 virus carrying the A245T amino acid mutation in NA gene showed reduced sensitivity to oseltamivir and highly reduced sensitivity to zanamivir. Conclusion The majority of influenza B viruses circulating in main-land China during 2014 to 2015 were sensitive to NAIs, which indicated that NAIs could be used continually for clinical treatment of patients with influenza. Sustained monitoring of antiviral susceptibility of influenza B viruses should be emphasized for timely detection of antiviral resistant viruses and more attention should be paid to the D197N mutations in NA gene of influenza B viruses.